December 5, 2024 • 44 mins
Join us for an illuminating conversation with naturopath Greta Durston as she shares her expertise on vaginal microbiome health. Drawing from both personal experience and clinical practice, Greta offers critical insights into the complex world of sexual health, from testing and diagnosis to evidence-based treatment strategies.
From exploring the historical understanding of vaginal microbiota to discussing cutting-edge approaches to managing infections, this episode provides healthcare practitioners with essential knowledge for supporting patients with vaginal health concerns. Greta's comprehensive approach emphasises the importance of accurate testing, targeted treatments, and understanding the intricate relationships between different microbiomes.
Key Episode Highlights:
- The evolution of vaginal microbiome understanding, from 19th-century discoveries to modern classifications, including how hormones and genetics influence vaginal health.
- Critical insights into testing methodologies for both male and female patients, with special focus on challenging organisms like mycoplasma.
- The complex interaction between seminal and vaginal microbiomes, including infection transfer risks and the importance of protective measures.
- Evidence-based treatment approaches using natural agents like berberine, NAC, pomegranate, and targeted probiotics for vaginal health.
- Understanding the role of biofilm disruption and inflammation management in treating vaginal infections effectively.
- The broader impact of vaginal health on mental wellbeing and self-perception, emphasising the need for greater awareness and understanding.
This episode is essential listening for practitioners seeking to enhance their knowledge of vaginal microbiome health and develop more effective treatment strategies for their patients.
About Greta
Greta Durston is a degree-qualified naturopath with a keen interest in reproductive health and the vaginal microbiome. Greta’s expertise extends beyond a classic Naturopathy degree as she has taken extensive specialised training in hormonal & vaginal microbiome assessment and treatment and has been mentored by some of the biggest names in the industry.
As a naturopath, Greta focuses on the underlying cause of your health concerns and utilises her case taking skills as well as functional pathology and evidence based treatments to achieve results for her clients. Greta has a collaborative, educational and patient-focused approach when communicating with her clients and aims to create a safe, inclusive space for all.
Contact Greta
Greta Naturopathy
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DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:19):
Music.
This is Wellness by Design, andI'm host Andrew Whitfield-Cook,
and joining us today is GretaDurston, a naturopath who
specialises in helping women,and indeed couples, with sexual
health, and today we're going tobe discussing the vaginal
microbiome.
Welcome to Wellness by Designs,Greta.
How are you?
Speaker 2 (00:40):
Thank you, I'm great.
I'm really looking forward tochatting today.
Thanks for having me on.
Speaker 1 (00:44):
Thank you, I'm great.
I'm really looking forward tochatting today.
Thanks for having me on.
Well, this is obviously a veryinteresting topic and you and I
know somebody that you'velearned from, so take us through
.
How did you learn about thevaginal microbiota?
What was it that got you reallyinterested?
Speaker 2 (01:00):
Yeah.
So I guess my interest reallycomes from my own personal
experience, which is the samefor a lot of health
practitioners.
When I was studying naturopathy, I was probably in my second or
third year of naturopathy and Ihad my own symptomatic
mycoplasma infection, which is asexually transmitted infection.
(01:21):
It's quite underdiagnosedsexually transmitted infection.
It's quite underdiagnosed.
And for myself I wasmisdiagnosed for two years,
which means that I ended upgetting pelvic inflammatory
disorder from that infection,which was misdiagnosed as
chronic thrush BV, lots of otherthings.
I even went to the hospitaltwice with extreme pelvic pain
(01:41):
and was just dismissed and toldto take Panadol.
So it took a lot for mydiagnosis.
I also had a naturopath at thetime who did offer some
treatments, but I really onlyhad, you know, vaginal
probiotics or, you know, putyogurt on a tampon and put that
in your vagina.
That was kind of the onlytreatment I was offered.
So when I was sort of finishingmy degree and doing my clinic
(02:07):
student clinic I just really gotinterested in that whole area
of the vaginal microbiome, gotreally into hearing Dr Moira
Bradfield talking and she had alot of training on her website.
That I did and then I went onto study with her for six months
post my graduation and, yeah,learn all things vaginal
(02:28):
microbiome through her.
Speaker 1 (02:30):
So tell us what we know so far, because, like back
in the old days of nursing, andwe're only talking, you know, 30
years ago, and that's not a lotwhen you consider the progress
that's been made in so manyother areas, even, let's say,
the early 2000s, it was stillmentioned with regards to the
(02:51):
vaginal microbiota, thedodeylanes bacillus, what you
know, which was, I think, laterteased out to be a lactobacilli.
So there's really only thisrecent exploration into the, the
milieu of the vaginalmicrobiota yeah, that is such a
funny term, isn't it?
Speaker 2 (03:12):
and I actually had never heard that until this year
, when I was doing some researchfor another talk that I did, um
, and then I went down thatrabbit hole of how that came
about.
Um, and, yeah, so thisgynecologist in what was it?
1890s, early 1890s, albertDaudelaine.
He made that term theDaudelaine lactobacillus, or
(03:34):
Daudelaine's bacillus, I thinkthey called it, which was the
type of lactobacillus thatthey'd found in the vaginal
microbiome, different to thelactobacillus species that
they'd found in the gutmicrobiome, in that they have
more ability to like, clumptogether and adhere to the
vaginal and vulval walls, sothat was kind of all we knew.
Yeah, that was sort of all weknew until much more recently.
(03:58):
So the first study published ofthe vaginal microbiome as a
whole and kind of classifyingthe vaginal microbiome, was in
2002.
So that's, you know, over ahundred years gap.
Speaker 1 (04:11):
Okay, so how have we progressed since then, though?
Speaker 2 (04:15):
So since 2002, we now have much more studies on the
vaginal microbiome and reallyclassifying them.
So we now know there'sdifferent CSTs which you might
have heard of, so communitystate types, which kind of tells
us about the types oflactobacillus that are dominant
in different microbiomes andtherefore how protective they
(04:37):
are.
So that was a really big stepin kind of understanding
different microbiomes and thenthat wasn't just one type.
There's also more research nowon, you know, how hormones
affect the vaginal microbiomeand even how you know women of
different ascent, like Africandescent, are less likely to have
(04:58):
a lactobacillus-dominatedmicrobiome.
So there's so many factors thatwe didn't think of before that
are now actually have research.
So there's so many factors thatwe didn't think of before that
are now actually have researchRight, so forgive me.
Speaker 1 (05:08):
so this is African descent, but living in a Western
civilisation, or African womenin Africa.
Speaker 2 (05:15):
Both, actually.
Yeah, it depends how far theirancestry goes back.
So it's more about theenvironment that their mothers
grew up in, right, and whatkinds of microbes their mothers
came into contact with.
Wow, yeah.
Speaker 1 (05:33):
Interesting, isn't it ?
So this sort of goes on alittle bit, I guess, from the
work.
When they were talking about.
This was the microbiome projectand there was the guy I can't
remember his name who went overto live with the Hadza tribe in
Africa and, interestingly,because they didn't have milk,
they were the truehunter-gatherers.
(05:54):
So they didn't have the what doyou call it, the farming
civilisation.
They moved with the animals andhunted for for the animals and
so milk wasn't really in theirdiet and they didn't have um,
bifidobacteria um, or theydidn't have big.
Yeah, after sorry, after birth,it weaned, it went.
(06:16):
Once the kids were weaned, it,uh, dropped off, their
populations dropped off.
So that's really interestingabout lactobacilli as well.
Speaker 2 (06:25):
Yeah, so the women of African descent and some other
cultures as well.
They actually have lowerlactobacillus species and can be
more bifidobacterium dominantin the vagina as well, which
then sets them up for a bit morerisk with things like BV and
other infections.
Speaker 1 (06:45):
Forgive me, so.
So, because they don't have thelactobacilli, sets them up for
bv.
Speaker 2 (06:51):
Yeah, so the um, the lactobacilli, is the most you
know protective bacteria for thevaginal microbiome.
So if we don't have that levelof protection, um, and we've
replaced it with something likebifidobacterium, which is not as
protective but you candefinitely have a
bifidobacterium-dominatedvaginal microbiome, we then
don't have that level of, youknow, ph balance and protection
(07:14):
against other bacteria.
Speaker 1 (07:16):
Okay, so can you take us through some of the more
common infections that you seein clinic?
So we'll sort of go backwardsto the infections and then we'll
come forward again to themicrobes that are implicated in
protection and maybe treatment.
Speaker 2 (07:30):
Yeah, yeah, absolutely yeah.
So there's a few kind ofclassifications with infections.
So the two that we're probablymost familiar with is BV or
bacterial vaginosis, and thrush.
So the difference between thosetwo would be that thrush is a
fungal infection, usually causedby candida albicans but there's
(07:51):
lots of other candidas that cancause it as well.
And then bacterial vaginosis isreferring to a dysbiosis in the
vagina between the bacteria.
So it's not fungal, it's justbacterial.
And when we talk about bacterialvaginosis, there's a few kind
of criteria that need to be metfor an actual bacterial
vaginosis diagnosis.
(08:13):
And it's tricky becausesometimes you'll just miss out
on that diagnosis and not reallyknow what to treat.
So with bacterial vaginosis,the three criteria there would
be that the pH needs to be above4.5.
There's a decrease inlactobacillus species and then
an overgrowth of one or moreanaerobic bacteria.
(08:35):
And it's really important thatwe understand the differences
between anaerobic and aerobicbacteria, because there's
another infection called aerobicvaginitis, which is basically
bacterial vaginosis, but withaerobic bacteria.
And you know, the differencesbetween anaerobic and aerobic
bacteria really dictate how wetreat it as well.
(08:56):
So with bacterial vaginosis,the anaerobic bacteria, it
refers to bacteria that doesn'tneed air to survive, whereas
aerobic bacteria refers tobacteria that does do a lot
better with air and can grow andpopulate in air environments.
(09:18):
So even if you just think aboutthat alone, things like wearing
non-breathable underwear willput you at a higher risk of
bacterial vaginosis.
So anything where you'recreating that damp, dark space
with not a lot of breathability,that's putting you at more risk
for bacterial vaginosis.
Speaker 1 (09:38):
Okay, With regards to thrush, again, like we think
about the classical symptoms butthrush doesn't always fit into
those classical symptoms of thecottage cheese discharge, things
like that.
Can we go through that andmaybe tease apart some of the
little hints and tips to how todiagnose correctly?
Speaker 2 (09:57):
Yeah, absolutely so, I think for me.
I kind of think of thrush intwo categories, of acute thrush
or chronic thrush.
So acute thrush is more likeyou can understand why it
happened.
So maybe they took antibioticsand then they got a thrush
infection because we've killedoff some of the bacteria.
Now they have thisopportunistic fungal infection.
(10:18):
So that is like an acute thrush, you know, you might take some
antifungals, you might useantifungal cream and it's
probably going to resolve andnot come back again.
That is really like a purelyfungal infection in the vagina
which can be treated and movedon.
It's not really systemic innature.
(10:39):
That's where you're going tosee that really cottage cheese
discharge, maybe a yeasty sortof odor and some irritation as
well.
So maybe some itchiness orirritation.
So that kind of acute thrushmight be from the antibiotics,
from sex, from going to a hotenvironment, so those kinds of
(11:01):
acute type infections.
Then the chronic infections forthrush, when it becomes really
chronic or cyclical in nature,that's when the presentation
seems to change a fair bit.
So in that more chronic thrushyou might see no discharge at
all, there might not be any.
There might be like a littlebit of a white discharge, um, or
(11:25):
they can be like quite aliquidy, um gushy discharge with
little flecks of fungal bits,so not so much cottage cheese
but little tiny flecks where youcan see the um fungal infection
there.
Then the symptoms of theirritation would be quite
similar.
But it tends to get moreirritating the longer it's gone
on, because the longer you haveit, the longer you've got that
(11:48):
penetration of the candida intothe tissue which causes that
shedding of the tissue, whichcauses degradation.
So we've got a lot ofirritation, the tissue is being
degraded, you might have easierbleeding.
So with sexual intercourse youmight get bleeding.
So it's just quite differentsymptoms.
In that way, the longer it goeson as well, the more histamine
(12:13):
it produces.
So candida produces a hugeamount of histamine.
So it kind of becomes thisactually like a histamine-driven
infection.
Speaker 1 (12:22):
That's really interesting yeah.
Speaker 2 (12:23):
So yeah, I think that's a missing piece.
It kind of becomes thisactually like a histamine-driven
infection.
That's really interesting.
Speaker 1 (12:27):
Yeah.
So yeah, can I ask then and Iknow this is pharmacological
therapy, not natural therapy butdo you ever find that in these
chronic cases, an antihistaminecan sometimes take the load off
while you're doing othersupportive therapy to heal the
terrain?
Speaker 2 (12:44):
Yeah, yeah, it's a great question.
So if there's a lot ofirritation and a lot of
inflammation, then absolutelysometimes they can be useful.
I've certainly used them withclients before, especially if
it's you know sex and they'retrying to conceive or there's
something that's reallyirritating like that, I would
get them to take anantihistamine before sex if
(13:04):
that's their flare period.
That being said, obviously, ifyou're going to take an
antihistamine, it's not going to, you know, reduce the
production of histamine, whichis why I find it more useful to
use something like quercetin orsomething that really will stop
that production long term umsomething that really um will
(13:25):
stop that production long termgotcha.
Speaker 1 (13:26):
And so, with regards to the you spoke about, um
infections and, and you know,upon sex and things like that,
there's this um concept of pingpong infection.
Do you find, you know, goingfrom one to the other, one to
the other, and then it was sortof dismissed for a while.
I've seen it quite a bit whereyou know women come in going or
(13:51):
a husband.
So do you find either there's aping pong infection and do you
find that it's easy orfrustratingly hard to treat the
male?
Speaker 2 (13:56):
Yeah, it, I've definitely seen that multiple
times.
I I kind of take the approachof is it that it's actually
moving from one to the other?
Is that the only issue?
And it's usually not the onlyissue, it's usually that.
Well, one of the things that Isee a lot is that the female or
the woman's vaginal microbiomehas no protection.
(14:17):
The pH is already high, she'salready stressed, she's already
producing heaps of histamine, sothere's already all of these
factors going on in her worldthat mean she has less
protection against opportunisticbacteria.
So, yes, maybe there is somepassing between, but usually
they will have the same kind ofmicrobes if there are infections
(14:38):
.
And if she had enoughprotection and if she had enough
, you know, good hygienepractices and things like that
she might not get symptoms fromthose microbes.
That's definitely not with allof them.
So some of them we really doneed to eradicate in both
partners.
But I find you know, justmaking sure that the women's
vagina microbiome is as healthyas possible, that will give us
(15:01):
the most protection.
Speaker 1 (15:09):
And I know that we're sort of segwaying away from the
female just for a bit, but Ineed to cover this and that is
the practice nowadays of notcircumcising males.
Do you find that that's anissue with ping pong infection?
Do you find that some maleshave to go and get circumcised,
or do you just work around withthe treatment?
Speaker 2 (15:25):
Yeah, that's a great question actually.
I mean I haven't seen it be anissue really, but I am always
coaching them around washingunderneath the foreskin.
So, yeah, that might be anissue but it's a very easy
hurdle to get over because youcan just really wash it properly
and so if there's, you can seeand you can smell if there's
anything kind of getting stuckunder the foreskin, so that
(15:47):
doesn't tend to be too much ofan issue.
Where the issue comes with theping pong infection is usually
the seminal microbiome, which isso tricky because we have no
direct access to the seminalmicrobiome.
Yeah, it's not necessarilyabout what's on the head of the
penis, it's really the seminalmicrobiome.
Speaker 1 (16:02):
Yeah, it's not necessarily about what's on the
head of the penis.
It's really the seminalmicrobiome.
So therefore testing in themale would have.
You'd have to be looking forthe culprit yeah, yeah, so there
are.
Speaker 2 (16:12):
There's not a lot of them, but there are some seminal
microbiome tests that you cando, um, and then you get a good
idea of like everything that'sin the seminal microbiome.
The hard thing is treatment,because we don't have a direct
access.
It's not like you can put someherbs straight into the seminal
microbiome and flush it out.
It's a little bit different.
Yeah, not as comfortable withthe seminal microbiome.
(16:37):
There's not a lot of research onhow that happens the
translocation from the seminalmicrobiome to the vaginal
microbiome.
But there is some research nowthat has pointed to the theory
of the microbes actuallyattached to the semen.
So they like take a little rideon the semen into the vaginal
microbiome and that's how theyend up there.
So I think that's reallyinteresting that they can
(16:59):
actually invade the cells of thesemen and that it's being
carried in that way.
So it's always interesting justto talk about.
You know how the client has sex?
Are they using condoms, um, isthere a jaculent going into the
vagina or not?
So there's lots of differentkind of um factors there and
back to the vagina again.
Speaker 1 (17:19):
So you know, once the terrain's inflamed and upset,
any sort of you know couplingcauses would cause more
inflammation and set them up foranother sort of wave of
infection like I've just.
Speaker 2 (17:33):
I've had these poor frustrated.
Speaker 1 (17:35):
I've sent a couple to moira, actually because I just
went.
Oh my goodness yeah, yeah, yeah.
Speaker 2 (17:40):
And it's not only that, but yeah, it'll cause more
inflammation, um, and the moredegraded the tissue is, the
easier it is to tear.
So if you think about havingthose tiny little micro tears,
um, from intercourse, thenthat's like a hive for bacteria.
So that's, if there's anyopportunistic bacteria hanging
around, it's going to go andembed itself there.
So, yeah, yeah, there's lots ofdifferent risks with that as
(18:02):
well, and you know the vaginaltissue is such a soft, delicate
place and you know the penistissue is very hard.
So in itself, you know it comeswith some risks.
Speaker 1 (18:17):
We need to talk about assessments as well.
So you know, like if somebodyis going to do a general, like
an MSU or a general swab andthey're looking for you know,
forgive me and the labtechnician isn't alerted to
looking for a specific organism,then they'll just look for
general things like coliformsand things like that, and so, as
(18:37):
you say, the infections aremissed.
What do we need to be alert for?
To go listen.
Can you please look for this?
Speaker 2 (18:45):
yeah, that's a really great question.
So, yeah, you can get with umyour gps.
Obviously you can get swabsdone.
They'll look for the, you know,top um offending microbes in bb
and thrush um.
The other two, the one that Imentioned before, which is um,
mycoplasma um, it is a molecule,so these are like a parasite
that um can be found in thevaginal microbiome um.
(19:08):
So, uh, mycoplasma genitaliumum.
There's a couple of other types, um and urea plasma as well.
So those two, I believe, needto be tested every time you're
getting a swab as well, um justto rule them out, because if
they're there you're going tomiss them yeah, obviously males
very hard to swab, yeah, but youcould take a seminal fluid
(19:32):
sample, hopefully and catch yeah, it is.
It's honestly really tricky toget males tested properly.
Sometimes if there's a rash onthe penis or around the pelvic
area, then they might do a skinscrape or a swab so they might
find candida there or otherfunguses.
It's not very often that theydo that, and they do usually say
(19:55):
oh, that looks like candida,try this cream and then, if it's
not, maybe we'll do some othertests.
They can do urinary samples sothey could pick up microplasma
and urea plasma, differentfungal infections and BV
bacteria from the urine sampleas well, but it'll be smaller
amounts.
Speaker 1 (20:17):
So again you'd have to be writing on the request
please look for, becauseotherwise that might.
Speaker 2 (20:21):
Yeah, absolutely yeah , and in my experience, it is
quite hard to get the requestplease look for, because
otherwise that might yeah,absolutely yeah.
And in my experience it isquite hard to get the doctor to
then look for that if they'renot told to test for it usually.
Speaker 1 (20:32):
And what about things like?
We spoke about micro tears inthe lining of the vagina.
I remember Moira telling meabout different types of
lubricants that some are moreeffective, some might even have
an irritating effect and somemight actually help bad bacteria
to grow.
Can we go through those?
What sort of things arerecommended?
Speaker 2 (20:55):
Yeah, definitely yeah .
So I usually recommend using anorganic lubricant, usually
water-based, so there's either awater-based or an oil-based
lubricant.
So it's about the type oflubricant it is.
And then the ingredients, thespecific ingredients.
So a really big one that wealways talk about is using a
(21:15):
non-glycerin lubricant, sosomething that doesn't have
glycerin in there.
There's varying research intohow glycerin can feed fungal or
bacterial infections.
The jury is honestly a littlebit out on it.
It doesn't seem to be reallywell researched into whether
it's actually an issue topically, and usually for me and my
(21:37):
clients it's usually aboutmaking sure you're washing that
off.
If you do have a lubricantthat's maybe not so vagina
microbiome friendly, definitelywashing it off.
So you might not see thoseeffects if you're, you know,
using it for five or 10 minutes,but if it's staying in there,
you will start to see thoseeffects.
So glycerin also being pHbalanced as well.
(21:58):
So pH balance to the vaginalmicrobiome is a big one.
So we want that pH to bebetween about 3.5 and 4.5.
Then there's also other moreprotective ingredients that are
in the more natural lubricants.
So things like aloe vera, youknow things that can be really
(22:18):
soothing and also repairing tothe vaginal tissue as well, and
then in cases, like you know,perimenopausal or menopausal
clients, we have a little bitmore of that tissue degradation.
So we want to be really carefulto be promoting the tissue, the
vaginal tissue health.
So then that's where theoil-based lubricants can be more
(22:40):
helpful as well.
So a bit more soothing, providea bit more protection.
Speaker 1 (22:47):
And can I ask, do any of these lubricants have maybe
a base or an addition with, say,coconut oil, like caprylic acid
, the antifungal actions ofcaprylic acid or anything like
that?
Moira was very interested inbutyrate.
Speaker 2 (23:04):
Yeah, yeah, fungal actions of caprylic acid or
anything like that.
Um, moira was very interestedin butyrate.
Yeah, yeah, I haven't heard hertalk about um butyrate in in
lubes before.
Um, I personally steer awayfrom coconut oil as a lubricant,
mostly because it is um, it's areally high ph and it really
can just throw the ph out.
That's not to say that I don'thave some clients that use it
and it works for them, but um,we don't really usually um
(23:26):
recommend um coconut, coconutoil as a lubricant.
Um it can.
Yes, it does have thatantibacterial, antifungal
activity.
Um, but we don't know how muchthat kind of affects the, the
beneficial flora um and theflora that we actually don't
want to grow, like candida andyou know those anaerobic
bacteria.
Speaker 1 (23:47):
Right.
So with treatment, obviouslywe're going through prevention
and general maintenance andsexual contact, things like that
.
What about treatments?
You mentioned right at thebeginning about the issues with,
you know, not having things onhand, and part of this was
actually a restriction, partlyunderstandable, by the
(24:10):
therapeutic goods administration, where at one stage we had
pessaries, probiotics in apessary form that we could give,
and now there was that decisionmade by the TGA to say no,
that's considered internal, soanything internal has to be
sterilized.
Therefore your bacteria iskilled.
How do we navigate this one?
Speaker 2 (24:32):
Yeah, yeah, I definitely have some views on
this.
So there are a lot of you knowvaginal probiotics out there
that have really good researchon being intravaginal probiotics
.
It really just is about thelabeling and I guess you know if
we're talking to practitioners,it is up to our own you know
our own knowledge and our ownprescription to be able to tell
(24:55):
our clients whether it's safe ornot to use intravaginally.
Usually you can ask you knowthe reps of different the
vaginal probiotics and see if itis safe to put intravaginally
um.
Usually you can ask you knowthe reps of different um the
vaginal probiotics and see if itis safe to put um
intravaginally, because it'susually just about the labeling
yeah there is a um I guess, thebrand new sorry there is.
Speaker 1 (25:14):
I was just going to interject, um, sorry, I was just
going to interject, um.
I guess the decision from apractitioner point of view is
well, do I give something thathas some evidence with treatment
effect, or does the patientrely on then going to the
supermarket and getting a mostprobably dead yoghurt which has
(25:40):
very little effect?
So it's sort of like well, it'srisk to benefit, isn't it?
Speaker 2 (25:45):
Yeah, yeah, exactly, and I guess my advice around
that would just to be using aprobiotic that has really good
translocation.
So if you do want to be justusing them orally, we need to
make sure that we're usingstrains that have been shown in
the research to translate fromthe gut microbiome over to the
vaginal microbiome, becausethat's what it's doing, right,
(26:05):
like you're eating it.
It needs to survive yourstomach, it then needs to
survive your gut, it then needsto come out in your poo and then
translocate over the perineumto the vaginal microbiomes, like
that's the reality of it.
So you want to make sure you'reusing really specific strains
that have been shown in theresearch to do that.
Speaker 1 (26:27):
And one of the other things I remember this is
decades ago now, but I was.
I had this predilection forzinc, zinc, zinc, zinc, zinc.
Everybody was zinc deficientzinc, zinc, zinc, zinc.
And there was these ladies thatwould walk past me where I used
to consult in the pharmacy, andthey'd walk past me to go and
get their um myconazole cream.
(26:47):
And then it was only after, andit was after months I suddenly
went hang on, I'm not gettingsomething here.
Iron yeah many of them were irondeficient, so can we go?
Can we have a chat about howmuch work you do about the
terrain, the sort of base healthof the patient and their immune
(27:08):
response health, their immunecapacity?
Speaker 2 (27:11):
Yeah, yeah.
So yeah, I always come from a.
You know both sides of thatstory, so you know.
Treating internally what arethe factors?
Why do you have this infection?
Not just let's treat theinfection, but how did we get
here, like, why couldn't yourimmune system deal with it?
And then also treatingintravaginally.
So I do a bit of both.
I'm always treating orally,working on their health as a
(27:34):
whole.
Is it blood sugar?
Is it their immune system?
Do they have deficiencies,things like that?
Are they deficient in nutrients?
Where that impacts your tissuehealth, where it impacts your
ability to grow more layers ofyour vaginal tissue.
So it's those kinds of thingsthat we want to work on
internally as well and thosethings take a long time as well.
(27:55):
So to get the most, um, themost sort of uh symptom relief
is when we also want to do thatum, intravaginal treatment.
So in terms of uh things thatwe can do orally, we want to
kind of assess like what, why?
Why is this happening for them?
So is it their immune system?
(28:15):
Like you said?
Is it an iron deficiency?
Do we need to give them zinc?
Are they zinc deficient?
Sometimes it is, and you know,things like if there's insulin
resistance going on is a hugeone for candida infections.
So that and so treatment withthat, with insulin resistance?
(28:40):
Yeah, so, with insulinresistance, I mean it's a lot
about, um us changing their dietas well.
Um, so changing their diet,opting for um smaller protein
rich meals.
Um, treatment wise, we can domyo-inositol.
I know you've spoken a lotabout that in your podcast
before.
Um, so yeah, we can always domyo-inositol.
I know you've spoken a lotabout that in your podcast
before.
Um, so yeah, we can always domyo-inositol.
Um, that's usually all I reallysee that they need is those
(29:00):
things.
Sometimes I'll do phgg andmyo-inositol together for
vaginal treatment, and that'sgiving us a prebiotic for the
lactobacillus species, as wellas balancing the blood sugar as
well.
Speaker 1 (29:13):
Okay.
So I have a question here.
One of the treatments that weuse for, certainly,
cardiovascular cholesterol,lipids, that sort of stuff, but
also in part with insulinresistance, is berberine, and
there's this ongoing argumentabout long-term.
Berberine might help theinsulin resistance, but is it
killing your bacteria?
What have you seen in clinic?
(29:34):
What are the changes?
Speaker 2 (29:37):
Yeah, look, I kind of stay away from it.
My opinion is I don't do a lotof berberine.
I will use it for short periodsof time, but I'm a microbiome
naturopath, right?
So my top kind of priority isthe microbiome.
So if I've got other thingsthat can work just as well and
I'm not going to be affectingboth the gut microbiome and the
(29:58):
vagina microbiome, um, I'mprobably not going to use
berberine long term.
I do think that it's reallyinteresting and there are, um I
want to see some, you know somemore studies on using particular
doses, um with those types ofthings.
But, um, yes, it's useful.
No, I wouldn't use it long term.
Speaker 1 (30:15):
Yeah, I think I agree , Like we need more data on it.
Might do this, but at whatexpense?
When you've got this condition,if they don't have that problem
, go nuts.
But if you do have this problem, are you undoing what you're
trying to treat, sort of thing.
Speaker 2 (30:31):
Yeah, and is there maybe a lower dose that we could
use for longer periods?
Speaker 1 (30:37):
salient point.
What about other gut sort of umtreatments?
If we're talking about themicrobiota from the gut, then
inoculating the vagina um, whatelse can we use that you've
found favorable?
Speaker 2 (30:50):
yeah.
So a really um, well-researchedcombination of probiotics is
the lactobacillus rhamnosus GR1and lactobacillus ruteri RC14.
They're the most kind ofstudied combo for boosting the
vaginal lactobacillus and that'soral root as well, especially
with things like strep B.
(31:11):
There are quite a few studieson that combination of crowding
out strep B.
There are quite a few studieson that combination of crowding
out strep B and it also,interestingly, is used to crowd
out strep B in the gut.
So you're kind of doing both.
If you really think it's comingfrom the gut, it's interesting
to just use those specificprobiotics internally.
We can also similarly use SBinternally which will reduce the
(31:37):
yeast in candida candida yeastin thrush, translocating from
the digestive tract to thevaginal microbiome.
Speaker 1 (31:45):
So those are a lot of the probiotics that I would
generally use.
Could you take?
Us through dosage regimen onthat at all with SB, like how
high do you go?
I've been very heroic with SByeah, I usually do.
Speaker 2 (32:01):
It kind of depends on the um, the dose in each
capsule.
I usually do two capsules twicedaily, but there are some that
are a much higher dose and youcan get away with one capsule
twice daily.
Um, but of the kind of standardold school dose, I think the
designs for health, one might bea high dose, but I do think, um
(32:21):
, yeah, usually you can go fortwo twice a day uh, anything
else, um so general gut healing,um pectin, salivary glutamine,
that sort of thing do you everuse that?
yeah, absolutely like all thekind of general gut healing will
almost always help um.
The more specific things that Ido use would be things that I
(32:43):
know that are going to help togrow um the lactobacillus
species.
So lactoferrin is amazing um,even orally, um same with
lactulose.
But you do need to be kind ofcareful with um lactulose in
that it will also feed aerobicbacteria.
So if you've got aerobicvaginitis we don't want to use
um lactulose.
Speaker 1 (33:04):
But lactoferrin is um quite safe and you're just
using it orally yeah, at lowdoses, because if you use the
full dose don't go out yeah,yeah, definitely low doses.
Speaker 2 (33:12):
Yeah, yeah, you might the full dose don't go out.
Yeah, yeah, definitely lowdoses.
Yeah, yeah, you might make, um,some running stools otherwise,
um, but anything that's going tokind of help with that tissue
healing in the gut is also goingto be beneficial for the vagina
as well, and anything wherewe're um, we're helping to break
down biofilms the really bigone that we haven't discussed
yet um, and also helping toreduce inflammation as well.
(33:35):
So some of the things that youcan use, even orally, to help
with the biofilm degradationwould be things like NAC is
incredible at that A couple ofherbs, pomegranate, green tea
both of those have selectiveantimicrobial actions, so they
do target those moreopportunistic bacteria and don't
(33:57):
have an effect on thelactobacillus.
That's really important too,which is what I would use over
berberine.
Speaker 1 (34:03):
Right, mike Ash some years ago mentioned something
and this is a different end ofthe body, I get it, but he was
talking about chronic sinusitismixing sb with nac into a glass
and putting a cotton bud andbasically inoculating your nose
with both the sb and the topicalapplication of nac.
(34:26):
Have you ever done thatvaginally?
Have you ever had experiencewith nac vaginally?
Yeah, oh, yeah, yeah,absolutely, take us through this
please.
Speaker 2 (34:34):
You can do it, yeah, so with the vaginal treatment,
I'm always thinking about whatdo we need to do for the
specific microbe that was found,or microbes that were found.
Is it likely to create biofilms?
Do we need to break those down?
So we need something that'sgoing to break them down.
Do we need to change the pH?
Do we need to change the ph?
Do we need to actually kill themicrobe?
And what is the right herb forthat?
(34:55):
Um, so all of that we can do umtopically.
So topically, um nac vitamin c,just ascorbic acid um and bacal
skull cap actually, um aregreat at breaking down biofilms
in the vagina.
So we can do that with thingslike rinses.
Sometimes we use a really lowdose hydrogen peroxide as like
(35:15):
the base of a rinse, adding inherbs or nutrients into there,
and then you can just apply thattopically, so with a syringe
into the vagina to help breakdown the biofilms.
So then when you're deliveringsomething antimicrobial in a
cream or a pessary or whateverelse it might be, you have more
of a direct access to that,without all the biofilm in the
(35:36):
way what's your view of the um,the pharmaceutical um creams on
the market like the?
Speaker 1 (35:46):
you know the um creams used to acidify the
vagina and things like that.
Have you found good effect withthose as a supportive therapy?
Speaker 2 (35:56):
Yeah, do you mean things like boric acid and
lactic acid or things that aremore like antifungal and
antibacterial?
Speaker 1 (36:03):
Things like Vagisil and yeah, that sort of thing.
Speaker 2 (36:09):
Yeah, I believe Vagisil, from memory, is a
lactic acid based product um.
I have had some clients usinglactic acid um and I mean that's
what our lactobacillus produceslactic acid.
So it can be really beneficialum to use the lactic acid.
But they all kind ofinterchangeable.
So lactic acid, vitamin c,boric acid, um, all of those
(36:30):
things um are aimed at reducingthe ph.
So if we can, you know, reducethe ph in between that 3.5 and
4.5 for healthy vaginalmicrobiome, and we can boost up
the lactobacillus species a lotof the time that's all we need.
It's not always, but, you know,a lot of the time we just need
to create the right environmentthat things will sort themselves
(36:51):
out.
Speaker 1 (36:53):
Right.
Can I ask also about species?
Not necessarily strains here,because we're talking food, but
things like, you know, yourfermented foods, so the
lactobacillus plantarums.
Then you've got cheeses, forinstance.
So we're talking short-chainfatty acids, lactic acid, the
(37:15):
propionibacterium Freudian Reiki.
There you go.
I remembered it.
In Swiss cheese it's Edamcheese, emmental cheese.
So these are foods.
We don't often think of them astherapy in this, certainly not
a cheese.
And then we've, you know,usually got this an idea of
(37:35):
trying to avoid too much dairy.
Do you find in the, in thisinstance, that some of these
foods can actually be useful?
Speaker 2 (37:44):
this is so interesting because you'd think
so with the strain specificityin those um foods.
But those foods also reallyhigh histamine producing foods.
So, you know, dairy they'rethings that are like cultured,
they're things that are, yes,they have the bacteria there,
but they also have this hugehistamine load.
(38:04):
So they're not necessarilythings that I would recommend
because of the histamine side ofthings.
There definitely are some foodsthat have more specific strains
for the vaginal microbiome.
So, um, coconut yogurt is one ofthem.
It's not dairy, it's, you know,coconut yogurt.
Um, it's really high inlactobacillus strains,
specifically because of the waythat they manufacture it.
(38:26):
So if you get a wild fermentedcoconut yogurt and coconut kefir
as well, um, actually, uh,cow's milk or goat's milk kefir
does have a lot less um lactoseand it does have the?
Um, the lactobacillus speciesin there as well.
So you can get away with someum, some dairy products there,
(38:47):
um, but yeah, so things like, uh, either the?
Um kefir or the coconut yogurt,um, also things like green tea,
like things that are, yes,they're antimicrobial but they
have a beneficial action on thelactobacillus species.
So we need to just think aboutis there any negative effect as
well?
Speaker 1 (39:06):
Yeah, sure, I've learned so much from this.
This is great, this is reallygood.
But I think it's really asalient point that you give me,
certainly, and that is to always, whatever you're thinking,
always keep in mind what youmight be producing.
Like you spoke about the um,the caprylic acid potentially,
the coconut oil, lubricantspotentially upsetting the um,
(39:30):
the ph of the vagina, and thenthe the um.
You know good dairy products ifyou like, but then they're high
histamine.
So you've always got to thinkabout this risk to benefit.
And what are you doing?
Are you causing collateraldamage?
Speaker 2 (39:43):
yeah, absolutely thinking about these things
holistically.
Yeah, thinking about the wholeperson and what is the effect,
and that's why it's really not Ihave this microbe and I'm going
to treat that it's.
I have this microbe.
Why did I get this microbe?
What's going wrong within mybody, or you know what do I need
to support, what body systemsaren't quite right, and you know
(40:03):
what other things is thismicrobe producing?
Some microbes produce their ownhistamine, so there's, yeah,
lots of other things that youneed to kind of think about.
Speaker 1 (40:12):
So what about other we've spoken about the now I've
gone blank the RC14 and the GR1.
Yeah, that's right.
So what are the probiotics Like?
What about lactobacillusrhamnosus GG, for instance, the
hero of all probiotics which Idon't believe in heroes, but do
(40:36):
you ever use like a concert ofthem?
Do you ever use probiotics ingeneral?
Speaker 2 (40:41):
yeah, I use a lot of different probiotics.
I'm really specific with theprobiotics that I use, but I do
use a lot of the lgg, therhamnosus lgg, if there's any
immune stuff going on, whichthere almost always is, but
especially if it's a really um,chronic or embedded infection,
um, specifically in aerobicvaginitis I use it a lot as well
(41:02):
, um, and in chronic, um thrush,because it is impacting the
stability of our mast cells andour ability to reduce or, you
know, clear out histamine.
So when histamine and theimmune system come into play,
I'm definitely thinking lgg aswell, and I'll often put people
on multiple probiotics justbecause I want really really
(41:25):
specific strains and I might doone, one type inside the vagina,
intravaginally and then onetype orally.
So I'm trying to impact theimmune system orally and the gut
microbiome to impact thevaginal microbiome, and then I
might want something that'shaving a really direct impact on
the vaginal microbiome.
Speaker 1 (41:45):
Gotcha this is so interesting.
I'm learning so much.
Unfortunately, we're sort ofrunning out of time, but I could
talk to you all day.
This is fantastic.
Thank you, Greta, can I ask?
So people are going to want toknow like have you got any
courses that you helppractitioners with, or have you
written articles?
Speaker 2 (42:05):
This is my ultimate goal.
Actually, within the next yearor two, I would like to have a
practitioner course.
At the moment, I just have awebinar that's for clients, so
people who are studentnaturopaths.
You probably will get somethingout of it, but it is definitely
aimed at clients more thanpractitioners.
So, yeah, keep an eye out.
In the next year or two, Ishould hopefully have a course
(42:26):
going for practitioners andgoing through the kind of
nuances of treatment with thevagina microbiome.
Speaker 1 (42:32):
We'll be hassling you to make sure that gets
completed.
It's too important.
I mean, look, it's tooimportant a topic.
Women are really suffering, god, the women that I sent to Moira
one woman she was just.
She was so angry in love withher husband, but furious that
every time they made lovesomething that was supposed to
bring them together she ended upwith this horrible infection
(42:53):
and she was again on the, butfurious that every time they
made love something that wassupposed to bring them together
she ended up with this horribleinfection and she was again on
the roundabout.
And it was just this circle ofdespondency.
So I'm glad that people likeyou and Moira obviously have
found some way of being able toreally intercede in a truly
therapeutic way to help peoplewithin their lives.
(43:13):
I just love what you're doing.
Thank you so much.
Speaker 2 (43:16):
Thank you, yeah, thank you, it's yeah, and I just
can't go unmentioned that thishas such a huge impact on
people's mental health and justyour sense of self and sexuality
and you know, your your kind ofsensual self.
It can put you right off sex.
So I think it's reallyimportant that we're talking
about it now and there's a lotmore information out there.
Speaker 1 (43:39):
Greta Durston.
Thank you so much for joiningus today and thank you everyone
for joining us.
Remember you can pick all ofthe other podcasts on the
Designs for Health website.
I'm looking forward to awebinar from you soon, greta,
and all of the information.
We're going to put up as muchresearch as we can.
That's pertinent for thevaginal microbiome biota,
(44:00):
because it's such an importantand interesting topic and it's
moving ahead quite quickly now.
Thank you so much for joiningus today.
This is Wellness by Designs andI'm Andrew Whitfield-Cook.
Music.
This is Wellness by Design, andI'm host Andrew Whitfield-Cook,
and joining us today is GretaDurston, a naturopath who
specialises in helping women,and indeed couples, with sexual
health, and today we're going tobe discussing the vaginal
microbiome.
Welcome to Wellness by Designs,Greta.
How are you?
Speaker 2 (00:40):
Thank you, I'm great.
I'm really looking forward tochatting today.
Thanks for having me on.
Speaker 1 (00:44):
Thank you, I'm great.
I'm really looking forward tochatting today.
Thanks for having me on.
Well, this is obviously a veryinteresting topic and you and I
know somebody that you'velearned from, so take us through
.
How did you learn about thevaginal microbiota?
What was it that got you reallyinterested?
Speaker 2 (01:00):
Yeah.
So I guess my interest reallycomes from my own personal
experience, which is the samefor a lot of health
practitioners.
When I was studying naturopathy, I was probably in my second or
third year of naturopathy and Ihad my own symptomatic
mycoplasma infection, which is asexually transmitted infection.
(01:21):
It's quite underdiagnosedsexually transmitted infection.
It's quite underdiagnosed.
And for myself I wasmisdiagnosed for two years,
which means that I ended upgetting pelvic inflammatory
disorder from that infection,which was misdiagnosed as
chronic thrush BV, lots of otherthings.
I even went to the hospitaltwice with extreme pelvic pain
(01:41):
and was just dismissed and toldto take Panadol.
So it took a lot for mydiagnosis.
I also had a naturopath at thetime who did offer some
treatments, but I really onlyhad, you know, vaginal
probiotics or, you know, putyogurt on a tampon and put that
in your vagina.
That was kind of the onlytreatment I was offered.
So when I was sort of finishingmy degree and doing my clinic
(02:07):
student clinic I just really gotinterested in that whole area
of the vaginal microbiome, gotreally into hearing Dr Moira
Bradfield talking and she had alot of training on her website.
That I did and then I went onto study with her for six months
post my graduation and, yeah,learn all things vaginal
(02:28):
microbiome through her.
Speaker 1 (02:30):
So tell us what we know so far, because, like back
in the old days of nursing, andwe're only talking, you know, 30
years ago, and that's not a lotwhen you consider the progress
that's been made in so manyother areas, even, let's say,
the early 2000s, it was stillmentioned with regards to the
(02:51):
vaginal microbiota, thedodeylanes bacillus, what you
know, which was, I think, laterteased out to be a lactobacilli.
So there's really only thisrecent exploration into the, the
milieu of the vaginalmicrobiota yeah, that is such a
funny term, isn't it?
Speaker 2 (03:12):
and I actually had never heard that until this year
, when I was doing some researchfor another talk that I did, um
, and then I went down thatrabbit hole of how that came
about.
Um, and, yeah, so thisgynecologist in what was it?
1890s, early 1890s, albertDaudelaine.
He made that term theDaudelaine lactobacillus, or
(03:34):
Daudelaine's bacillus, I thinkthey called it, which was the
type of lactobacillus thatthey'd found in the vaginal
microbiome, different to thelactobacillus species that
they'd found in the gutmicrobiome, in that they have
more ability to like, clumptogether and adhere to the
vaginal and vulval walls, sothat was kind of all we knew.
Yeah, that was sort of all weknew until much more recently.
(03:58):
So the first study published ofthe vaginal microbiome as a
whole and kind of classifyingthe vaginal microbiome, was in
2002.
So that's, you know, over ahundred years gap.
Speaker 1 (04:11):
Okay, so how have we progressed since then, though?
Speaker 2 (04:15):
So since 2002, we now have much more studies on the
vaginal microbiome and reallyclassifying them.
So we now know there'sdifferent CSTs which you might
have heard of, so communitystate types, which kind of tells
us about the types oflactobacillus that are dominant
in different microbiomes andtherefore how protective they
(04:37):
are.
So that was a really big stepin kind of understanding
different microbiomes and thenthat wasn't just one type.
There's also more research nowon, you know, how hormones
affect the vaginal microbiomeand even how you know women of
different ascent, like Africandescent, are less likely to have
(04:58):
a lactobacillus-dominatedmicrobiome.
So there's so many factors thatwe didn't think of before that
are now actually have research.
So there's so many factors thatwe didn't think of before that
are now actually have researchRight, so forgive me.
Speaker 1 (05:08):
so this is African descent, but living in a Western
civilisation, or African womenin Africa.
Speaker 2 (05:15):
Both, actually.
Yeah, it depends how far theirancestry goes back.
So it's more about theenvironment that their mothers
grew up in, right, and whatkinds of microbes their mothers
came into contact with.
Wow, yeah.
Speaker 1 (05:33):
Interesting, isn't it ?
So this sort of goes on alittle bit, I guess, from the
work.
When they were talking about.
This was the microbiome projectand there was the guy I can't
remember his name who went overto live with the Hadza tribe in
Africa and, interestingly,because they didn't have milk,
they were the truehunter-gatherers.
(05:54):
So they didn't have the what doyou call it, the farming
civilisation.
They moved with the animals andhunted for for the animals and
so milk wasn't really in theirdiet and they didn't have um,
bifidobacteria um, or theydidn't have big.
Yeah, after sorry, after birth,it weaned, it went.
(06:16):
Once the kids were weaned, it,uh, dropped off, their
populations dropped off.
So that's really interestingabout lactobacilli as well.
Speaker 2 (06:25):
Yeah, so the women of African descent and some other
cultures as well.
They actually have lowerlactobacillus species and can be
more bifidobacterium dominantin the vagina as well, which
then sets them up for a bit morerisk with things like BV and
other infections.
Speaker 1 (06:45):
Forgive me, so.
So, because they don't have thelactobacilli, sets them up for
bv.
Speaker 2 (06:51):
Yeah, so the um, the lactobacilli, is the most you
know protective bacteria for thevaginal microbiome.
So if we don't have that levelof protection, um, and we've
replaced it with something likebifidobacterium, which is not as
protective but you candefinitely have a
bifidobacterium-dominatedvaginal microbiome, we then
don't have that level of, youknow, ph balance and protection
(07:14):
against other bacteria.
Speaker 1 (07:16):
Okay, so can you take us through some of the more
common infections that you seein clinic?
So we'll sort of go backwardsto the infections and then we'll
come forward again to themicrobes that are implicated in
protection and maybe treatment.
Speaker 2 (07:30):
Yeah, yeah, absolutely yeah.
So there's a few kind ofclassifications with infections.
So the two that we're probablymost familiar with is BV or
bacterial vaginosis, and thrush.
So the difference between thosetwo would be that thrush is a
fungal infection, usually causedby candida albicans but there's
(07:51):
lots of other candidas that cancause it as well.
And then bacterial vaginosis isreferring to a dysbiosis in the
vagina between the bacteria.
So it's not fungal, it's justbacterial.
And when we talk about bacterialvaginosis, there's a few kind
of criteria that need to be metfor an actual bacterial
vaginosis diagnosis.
(08:13):
And it's tricky becausesometimes you'll just miss out
on that diagnosis and not reallyknow what to treat.
So with bacterial vaginosis,the three criteria there would
be that the pH needs to be above4.5.
There's a decrease inlactobacillus species and then
an overgrowth of one or moreanaerobic bacteria.
(08:35):
And it's really important thatwe understand the differences
between anaerobic and aerobicbacteria, because there's
another infection called aerobicvaginitis, which is basically
bacterial vaginosis, but withaerobic bacteria.
And you know, the differencesbetween anaerobic and aerobic
bacteria really dictate how wetreat it as well.
(08:56):
So with bacterial vaginosis,the anaerobic bacteria, it
refers to bacteria that doesn'tneed air to survive, whereas
aerobic bacteria refers tobacteria that does do a lot
better with air and can grow andpopulate in air environments.
(09:18):
So even if you just think aboutthat alone, things like wearing
non-breathable underwear willput you at a higher risk of
bacterial vaginosis.
So anything where you'recreating that damp, dark space
with not a lot of breathability,that's putting you at more risk
for bacterial vaginosis.
Speaker 1 (09:38):
Okay, With regards to thrush, again, like we think
about the classical symptoms butthrush doesn't always fit into
those classical symptoms of thecottage cheese discharge, things
like that.
Can we go through that andmaybe tease apart some of the
little hints and tips to how todiagnose correctly?
Speaker 2 (09:57):
Yeah, absolutely so, I think for me.
I kind of think of thrush intwo categories, of acute thrush
or chronic thrush.
So acute thrush is more likeyou can understand why it
happened.
So maybe they took antibioticsand then they got a thrush
infection because we've killedoff some of the bacteria.
Now they have thisopportunistic fungal infection.
(10:18):
So that is like an acute thrush, you know, you might take some
antifungals, you might useantifungal cream and it's
probably going to resolve andnot come back again.
That is really like a purelyfungal infection in the vagina
which can be treated and movedon.
It's not really systemic innature.
(10:39):
That's where you're going tosee that really cottage cheese
discharge, maybe a yeasty sortof odor and some irritation as
well.
So maybe some itchiness orirritation.
So that kind of acute thrushmight be from the antibiotics,
from sex, from going to a hotenvironment, so those kinds of
(11:01):
acute type infections.
Then the chronic infections forthrush, when it becomes really
chronic or cyclical in nature,that's when the presentation
seems to change a fair bit.
So in that more chronic thrushyou might see no discharge at
all, there might not be any.
There might be like a littlebit of a white discharge, um, or
(11:25):
they can be like quite aliquidy, um gushy discharge with
little flecks of fungal bits,so not so much cottage cheese
but little tiny flecks where youcan see the um fungal infection
there.
Then the symptoms of theirritation would be quite
similar.
But it tends to get moreirritating the longer it's gone
on, because the longer you haveit, the longer you've got that
(11:48):
penetration of the candida intothe tissue which causes that
shedding of the tissue, whichcauses degradation.
So we've got a lot ofirritation, the tissue is being
degraded, you might have easierbleeding.
So with sexual intercourse youmight get bleeding.
So it's just quite differentsymptoms.
In that way, the longer it goeson as well, the more histamine
(12:13):
it produces.
So candida produces a hugeamount of histamine.
So it kind of becomes thisactually like a histamine-driven
infection.
Speaker 1 (12:22):
That's really interesting yeah.
Speaker 2 (12:23):
So yeah, I think that's a missing piece.
It kind of becomes thisactually like a histamine-driven
infection.
That's really interesting.
Speaker 1 (12:27):
Yeah.
So yeah, can I ask then and Iknow this is pharmacological
therapy, not natural therapy butdo you ever find that in these
chronic cases, an antihistaminecan sometimes take the load off
while you're doing othersupportive therapy to heal the
terrain?
Speaker 2 (12:44):
Yeah, yeah, it's a great question.
So if there's a lot ofirritation and a lot of
inflammation, then absolutelysometimes they can be useful.
I've certainly used them withclients before, especially if
it's you know sex and they'retrying to conceive or there's
something that's reallyirritating like that, I would
get them to take anantihistamine before sex if
(13:04):
that's their flare period.
That being said, obviously, ifyou're going to take an
antihistamine, it's not going to, you know, reduce the
production of histamine, whichis why I find it more useful to
use something like quercetin orsomething that really will stop
that production long term umsomething that really um will
(13:25):
stop that production long termgotcha.
Speaker 1 (13:26):
And so, with regards to the you spoke about, um
infections and, and you know,upon sex and things like that,
there's this um concept of pingpong infection.
Do you find, you know, goingfrom one to the other, one to
the other, and then it was sortof dismissed for a while.
I've seen it quite a bit whereyou know women come in going or
(13:51):
a husband.
So do you find either there's aping pong infection and do you
find that it's easy orfrustratingly hard to treat the
male?
Speaker 2 (13:56):
Yeah, it, I've definitely seen that multiple
times.
I I kind of take the approachof is it that it's actually
moving from one to the other?
Is that the only issue?
And it's usually not the onlyissue, it's usually that.
Well, one of the things that Isee a lot is that the female or
the woman's vaginal microbiomehas no protection.
(14:17):
The pH is already high, she'salready stressed, she's already
producing heaps of histamine, sothere's already all of these
factors going on in her worldthat mean she has less
protection against opportunisticbacteria.
So, yes, maybe there is somepassing between, but usually
they will have the same kind ofmicrobes if there are infections
(14:38):
.
And if she had enoughprotection and if she had enough
, you know, good hygienepractices and things like that
she might not get symptoms fromthose microbes.
That's definitely not with allof them.
So some of them we really doneed to eradicate in both
partners.
But I find you know, justmaking sure that the women's
vagina microbiome is as healthyas possible, that will give us
(15:01):
the most protection.
Speaker 1 (15:09):
And I know that we're sort of segwaying away from the
female just for a bit, but Ineed to cover this and that is
the practice nowadays of notcircumcising males.
Do you find that that's anissue with ping pong infection?
Do you find that some maleshave to go and get circumcised,
or do you just work around withthe treatment?
Speaker 2 (15:25):
Yeah, that's a great question actually.
I mean I haven't seen it be anissue really, but I am always
coaching them around washingunderneath the foreskin.
So, yeah, that might be anissue but it's a very easy
hurdle to get over because youcan just really wash it properly
and so if there's, you can seeand you can smell if there's
anything kind of getting stuckunder the foreskin, so that
(15:47):
doesn't tend to be too much ofan issue.
Where the issue comes with theping pong infection is usually
the seminal microbiome, which isso tricky because we have no
direct access to the seminalmicrobiome.
Yeah, it's not necessarilyabout what's on the head of the
penis, it's really the seminalmicrobiome.
Speaker 1 (16:02):
Yeah, it's not necessarily about what's on the
head of the penis.
It's really the seminalmicrobiome.
So therefore testing in themale would have.
You'd have to be looking forthe culprit yeah, yeah, so there
are.
Speaker 2 (16:12):
There's not a lot of them, but there are some seminal
microbiome tests that you cando, um, and then you get a good
idea of like everything that'sin the seminal microbiome.
The hard thing is treatment,because we don't have a direct
access.
It's not like you can put someherbs straight into the seminal
microbiome and flush it out.
It's a little bit different.
Yeah, not as comfortable withthe seminal microbiome.
(16:37):
There's not a lot of research onhow that happens the
translocation from the seminalmicrobiome to the vaginal
microbiome.
But there is some research nowthat has pointed to the theory
of the microbes actuallyattached to the semen.
So they like take a little rideon the semen into the vaginal
microbiome and that's how theyend up there.
So I think that's reallyinteresting that they can
(16:59):
actually invade the cells of thesemen and that it's being
carried in that way.
So it's always interesting justto talk about.
You know how the client has sex?
Are they using condoms, um, isthere a jaculent going into the
vagina or not?
So there's lots of differentkind of um factors there and
back to the vagina again.
Speaker 1 (17:19):
So you know, once the terrain's inflamed and upset,
any sort of you know couplingcauses would cause more
inflammation and set them up foranother sort of wave of
infection like I've just.
Speaker 2 (17:33):
I've had these poor frustrated.
Speaker 1 (17:35):
I've sent a couple to moira, actually because I just
went.
Oh my goodness yeah, yeah, yeah.
Speaker 2 (17:40):
And it's not only that, but yeah, it'll cause more
inflammation, um, and the moredegraded the tissue is, the
easier it is to tear.
So if you think about havingthose tiny little micro tears,
um, from intercourse, thenthat's like a hive for bacteria.
So that's, if there's anyopportunistic bacteria hanging
around, it's going to go andembed itself there.
So, yeah, yeah, there's lots ofdifferent risks with that as
(18:02):
well, and you know the vaginaltissue is such a soft, delicate
place and you know the penistissue is very hard.
So in itself, you know it comeswith some risks.
Speaker 1 (18:17):
We need to talk about assessments as well.
So you know, like if somebodyis going to do a general, like
an MSU or a general swab andthey're looking for you know,
forgive me and the labtechnician isn't alerted to
looking for a specific organism,then they'll just look for
general things like coliformsand things like that, and so, as
(18:37):
you say, the infections aremissed.
What do we need to be alert for?
To go listen.
Can you please look for this?
Speaker 2 (18:45):
yeah, that's a really great question.
So, yeah, you can get with umyour gps.
Obviously you can get swabsdone.
They'll look for the, you know,top um offending microbes in bb
and thrush um.
The other two, the one that Imentioned before, which is um,
mycoplasma um, it is a molecule,so these are like a parasite
that um can be found in thevaginal microbiome um.
(19:08):
So, uh, mycoplasma genitaliumum.
There's a couple of other types, um and urea plasma as well.
So those two, I believe, needto be tested every time you're
getting a swab as well, um justto rule them out, because if
they're there you're going tomiss them yeah, obviously males
very hard to swab, yeah, but youcould take a seminal fluid
(19:32):
sample, hopefully and catch yeah, it is.
It's honestly really tricky toget males tested properly.
Sometimes if there's a rash onthe penis or around the pelvic
area, then they might do a skinscrape or a swab so they might
find candida there or otherfunguses.
It's not very often that theydo that, and they do usually say
(19:55):
oh, that looks like candida,try this cream and then, if it's
not, maybe we'll do some othertests.
They can do urinary samples sothey could pick up microplasma
and urea plasma, differentfungal infections and BV
bacteria from the urine sampleas well, but it'll be smaller
amounts.
Speaker 1 (20:17):
So again you'd have to be writing on the request
please look for, becauseotherwise that might.
Speaker 2 (20:21):
Yeah, absolutely yeah , and in my experience, it is
quite hard to get the requestplease look for, because
otherwise that might yeah,absolutely yeah.
And in my experience it isquite hard to get the doctor to
then look for that if they'renot told to test for it usually.
Speaker 1 (20:32):
And what about things like?
We spoke about micro tears inthe lining of the vagina.
I remember Moira telling meabout different types of
lubricants that some are moreeffective, some might even have
an irritating effect and somemight actually help bad bacteria
to grow.
Can we go through those?
What sort of things arerecommended?
Speaker 2 (20:55):
Yeah, definitely yeah .
So I usually recommend using anorganic lubricant, usually
water-based, so there's either awater-based or an oil-based
lubricant.
So it's about the type oflubricant it is.
And then the ingredients, thespecific ingredients.
So a really big one that wealways talk about is using a
(21:15):
non-glycerin lubricant, sosomething that doesn't have
glycerin in there.
There's varying research intohow glycerin can feed fungal or
bacterial infections.
The jury is honestly a littlebit out on it.
It doesn't seem to be reallywell researched into whether
it's actually an issue topically, and usually for me and my
(21:37):
clients it's usually aboutmaking sure you're washing that
off.
If you do have a lubricantthat's maybe not so vagina
microbiome friendly, definitelywashing it off.
So you might not see thoseeffects if you're, you know,
using it for five or 10 minutes,but if it's staying in there,
you will start to see thoseeffects.
So glycerin also being pHbalanced as well.
(21:58):
So pH balance to the vaginalmicrobiome is a big one.
So we want that pH to bebetween about 3.5 and 4.5.
Then there's also other moreprotective ingredients that are
in the more natural lubricants.
So things like aloe vera, youknow things that can be really
(22:18):
soothing and also repairing tothe vaginal tissue as well, and
then in cases, like you know,perimenopausal or menopausal
clients, we have a little bitmore of that tissue degradation.
So we want to be really carefulto be promoting the tissue, the
vaginal tissue health.
So then that's where theoil-based lubricants can be more
(22:40):
helpful as well.
So a bit more soothing, providea bit more protection.
Speaker 1 (22:47):
And can I ask, do any of these lubricants have maybe
a base or an addition with, say,coconut oil, like caprylic acid
, the antifungal actions ofcaprylic acid or anything like
that?
Moira was very interested inbutyrate.
Speaker 2 (23:04):
Yeah, yeah, fungal actions of caprylic acid or
anything like that.
Um, moira was very interestedin butyrate.
Yeah, yeah, I haven't heard hertalk about um butyrate in in
lubes before.
Um, I personally steer awayfrom coconut oil as a lubricant,
mostly because it is um, it's areally high ph and it really
can just throw the ph out.
That's not to say that I don'thave some clients that use it
and it works for them, but um,we don't really usually um
(23:26):
recommend um coconut, coconutoil as a lubricant.
Um it can.
Yes, it does have thatantibacterial, antifungal
activity.
Um, but we don't know how muchthat kind of affects the, the
beneficial flora um and theflora that we actually don't
want to grow, like candida andyou know those anaerobic
bacteria.
Speaker 1 (23:47):
Right.
So with treatment, obviouslywe're going through prevention
and general maintenance andsexual contact, things like that
.
What about treatments?
You mentioned right at thebeginning about the issues with,
you know, not having things onhand, and part of this was
actually a restriction, partlyunderstandable, by the
(24:10):
therapeutic goods administration, where at one stage we had
pessaries, probiotics in apessary form that we could give,
and now there was that decisionmade by the TGA to say no,
that's considered internal, soanything internal has to be
sterilized.
Therefore your bacteria iskilled.
How do we navigate this one?
Speaker 2 (24:32):
Yeah, yeah, I definitely have some views on
this.
So there are a lot of you knowvaginal probiotics out there
that have really good researchon being intravaginal probiotics
.
It really just is about thelabeling and I guess you know if
we're talking to practitioners,it is up to our own you know
our own knowledge and our ownprescription to be able to tell
(24:55):
our clients whether it's safe ornot to use intravaginally.
Usually you can ask you knowthe reps of different the
vaginal probiotics and see if itis safe to put intravaginally
um.
Usually you can ask you knowthe reps of different um the
vaginal probiotics and see if itis safe to put um
intravaginally, because it'susually just about the labeling
yeah there is a um I guess, thebrand new sorry there is.
Speaker 1 (25:14):
I was just going to interject, um, sorry, I was just
going to interject, um.
I guess the decision from apractitioner point of view is
well, do I give something thathas some evidence with treatment
effect, or does the patientrely on then going to the
supermarket and getting a mostprobably dead yoghurt which has
(25:40):
very little effect?
So it's sort of like well, it'srisk to benefit, isn't it?
Speaker 2 (25:45):
Yeah, yeah, exactly, and I guess my advice around
that would just to be using aprobiotic that has really good
translocation.
So if you do want to be justusing them orally, we need to
make sure that we're usingstrains that have been shown in
the research to translate fromthe gut microbiome over to the
vaginal microbiome, becausethat's what it's doing, right,
(26:05):
like you're eating it.
It needs to survive yourstomach, it then needs to
survive your gut, it then needsto come out in your poo and then
translocate over the perineumto the vaginal microbiomes, like
that's the reality of it.
So you want to make sure you'reusing really specific strains
that have been shown in theresearch to do that.
Speaker 1 (26:27):
And one of the other things I remember this is
decades ago now, but I was.
I had this predilection forzinc, zinc, zinc, zinc, zinc.
Everybody was zinc deficientzinc, zinc, zinc, zinc.
And there was these ladies thatwould walk past me where I used
to consult in the pharmacy, andthey'd walk past me to go and
get their um myconazole cream.
(26:47):
And then it was only after, andit was after months I suddenly
went hang on, I'm not gettingsomething here.
Iron yeah many of them were irondeficient, so can we go?
Can we have a chat about howmuch work you do about the
terrain, the sort of base healthof the patient and their immune
(27:08):
response health, their immunecapacity?
Speaker 2 (27:11):
Yeah, yeah.
So yeah, I always come from a.
You know both sides of thatstory, so you know.
Treating internally what arethe factors?
Why do you have this infection?
Not just let's treat theinfection, but how did we get
here, like, why couldn't yourimmune system deal with it?
And then also treatingintravaginally.
So I do a bit of both.
I'm always treating orally,working on their health as a
(27:34):
whole.
Is it blood sugar?
Is it their immune system?
Do they have deficiencies,things like that?
Are they deficient in nutrients?
Where that impacts your tissuehealth, where it impacts your
ability to grow more layers ofyour vaginal tissue.
So it's those kinds of thingsthat we want to work on
internally as well and thosethings take a long time as well.
(27:55):
So to get the most, um, themost sort of uh symptom relief
is when we also want to do thatum, intravaginal treatment.
So in terms of uh things thatwe can do orally, we want to
kind of assess like what, why?
Why is this happening for them?
So is it their immune system?
(28:15):
Like you said?
Is it an iron deficiency?
Do we need to give them zinc?
Are they zinc deficient?
Sometimes it is, and you know,things like if there's insulin
resistance going on is a hugeone for candida infections.
So that and so treatment withthat, with insulin resistance?
(28:40):
Yeah, so, with insulinresistance, I mean it's a lot
about, um us changing their dietas well.
Um, so changing their diet,opting for um smaller protein
rich meals.
Um, treatment wise, we can domyo-inositol.
I know you've spoken a lotabout that in your podcast
before.
Um, so yeah, we can always domyo-inositol.
I know you've spoken a lotabout that in your podcast
before.
Um, so yeah, we can always domyo-inositol.
Um, that's usually all I reallysee that they need is those
(29:00):
things.
Sometimes I'll do phgg andmyo-inositol together for
vaginal treatment, and that'sgiving us a prebiotic for the
lactobacillus species, as wellas balancing the blood sugar as
well.
Speaker 1 (29:13):
Okay.
So I have a question here.
One of the treatments that weuse for, certainly,
cardiovascular cholesterol,lipids, that sort of stuff, but
also in part with insulinresistance, is berberine, and
there's this ongoing argumentabout long-term.
Berberine might help theinsulin resistance, but is it
killing your bacteria?
What have you seen in clinic?
(29:34):
What are the changes?
Speaker 2 (29:37):
Yeah, look, I kind of stay away from it.
My opinion is I don't do a lotof berberine.
I will use it for short periodsof time, but I'm a microbiome
naturopath, right?
So my top kind of priority isthe microbiome.
So if I've got other thingsthat can work just as well and
I'm not going to be affectingboth the gut microbiome and the
(29:58):
vagina microbiome, um, I'mprobably not going to use
berberine long term.
I do think that it's reallyinteresting and there are, um I
want to see some, you know somemore studies on using particular
doses, um with those types ofthings.
But, um, yes, it's useful.
No, I wouldn't use it long term.
Speaker 1 (30:15):
Yeah, I think I agree , Like we need more data on it.
Might do this, but at whatexpense?
When you've got this condition,if they don't have that problem
, go nuts.
But if you do have this problem, are you undoing what you're
trying to treat, sort of thing.
Speaker 2 (30:31):
Yeah, and is there maybe a lower dose that we could
use for longer periods?
Speaker 1 (30:37):
salient point.
What about other gut sort of umtreatments?
If we're talking about themicrobiota from the gut, then
inoculating the vagina um, whatelse can we use that you've
found favorable?
Speaker 2 (30:50):
yeah.
So a really um, well-researchedcombination of probiotics is
the lactobacillus rhamnosus GR1and lactobacillus ruteri RC14.
They're the most kind ofstudied combo for boosting the
vaginal lactobacillus and that'soral root as well, especially
with things like strep B.
(31:11):
There are quite a few studieson that combination of crowding
out strep B.
There are quite a few studieson that combination of crowding
out strep B and it also,interestingly, is used to crowd
out strep B in the gut.
So you're kind of doing both.
If you really think it's comingfrom the gut, it's interesting
to just use those specificprobiotics internally.
We can also similarly use SBinternally which will reduce the
(31:37):
yeast in candida candida yeastin thrush, translocating from
the digestive tract to thevaginal microbiome.
Speaker 1 (31:45):
So those are a lot of the probiotics that I would
generally use.
Could you take?
Us through dosage regimen onthat at all with SB, like how
high do you go?
I've been very heroic with SByeah, I usually do.
Speaker 2 (32:01):
It kind of depends on the um, the dose in each
capsule.
I usually do two capsules twicedaily, but there are some that
are a much higher dose and youcan get away with one capsule
twice daily.
Um, but of the kind of standardold school dose, I think the
designs for health, one might bea high dose, but I do think, um
(32:21):
, yeah, usually you can go fortwo twice a day uh, anything
else, um so general gut healing,um pectin, salivary glutamine,
that sort of thing do you everuse that?
yeah, absolutely like all thekind of general gut healing will
almost always help um.
The more specific things that Ido use would be things that I
(32:43):
know that are going to help togrow um the lactobacillus
species.
So lactoferrin is amazing um,even orally, um same with
lactulose.
But you do need to be kind ofcareful with um lactulose in
that it will also feed aerobicbacteria.
So if you've got aerobicvaginitis we don't want to use
um lactulose.
Speaker 1 (33:04):
But lactoferrin is um quite safe and you're just
using it orally yeah, at lowdoses, because if you use the
full dose don't go out yeah,yeah, definitely low doses.
Speaker 2 (33:12):
Yeah, yeah, you might the full dose don't go out.
Yeah, yeah, definitely lowdoses.
Yeah, yeah, you might make, um,some running stools otherwise,
um, but anything that's going tokind of help with that tissue
healing in the gut is also goingto be beneficial for the vagina
as well, and anything wherewe're um, we're helping to break
down biofilms the really bigone that we haven't discussed
yet um, and also helping toreduce inflammation as well.
(33:35):
So some of the things that youcan use, even orally, to help
with the biofilm degradationwould be things like NAC is
incredible at that A couple ofherbs, pomegranate, green tea
both of those have selectiveantimicrobial actions, so they
do target those moreopportunistic bacteria and don't
(33:57):
have an effect on thelactobacillus.
That's really important too,which is what I would use over
berberine.
Speaker 1 (34:03):
Right, mike Ash some years ago mentioned something
and this is a different end ofthe body, I get it, but he was
talking about chronic sinusitismixing sb with nac into a glass
and putting a cotton bud andbasically inoculating your nose
with both the sb and the topicalapplication of nac.
(34:26):
Have you ever done thatvaginally?
Have you ever had experiencewith nac vaginally?
Yeah, oh, yeah, yeah,absolutely, take us through this
please.
Speaker 2 (34:34):
You can do it, yeah, so with the vaginal treatment,
I'm always thinking about whatdo we need to do for the
specific microbe that was found,or microbes that were found.
Is it likely to create biofilms?
Do we need to break those down?
So we need something that'sgoing to break them down.
Do we need to change the pH?
Do we need to change the ph?
Do we need to actually kill themicrobe?
And what is the right herb forthat?
(34:55):
Um, so all of that we can do umtopically.
So topically, um nac vitamin c,just ascorbic acid um and bacal
skull cap actually, um aregreat at breaking down biofilms
in the vagina.
So we can do that with thingslike rinses.
Sometimes we use a really lowdose hydrogen peroxide as like
(35:15):
the base of a rinse, adding inherbs or nutrients into there,
and then you can just apply thattopically, so with a syringe
into the vagina to help breakdown the biofilms.
So then when you're deliveringsomething antimicrobial in a
cream or a pessary or whateverelse it might be, you have more
of a direct access to that,without all the biofilm in the
(35:36):
way what's your view of the um,the pharmaceutical um creams on
the market like the?
Speaker 1 (35:46):
you know the um creams used to acidify the
vagina and things like that.
Have you found good effect withthose as a supportive therapy?
Speaker 2 (35:56):
Yeah, do you mean things like boric acid and
lactic acid or things that aremore like antifungal and
antibacterial?
Speaker 1 (36:03):
Things like Vagisil and yeah, that sort of thing.
Speaker 2 (36:09):
Yeah, I believe Vagisil, from memory, is a
lactic acid based product um.
I have had some clients usinglactic acid um and I mean that's
what our lactobacillus produceslactic acid.
So it can be really beneficialum to use the lactic acid.
But they all kind ofinterchangeable.
So lactic acid, vitamin c,boric acid, um, all of those
(36:30):
things um are aimed at reducingthe ph.
So if we can, you know, reducethe ph in between that 3.5 and
4.5 for healthy vaginalmicrobiome, and we can boost up
the lactobacillus species a lotof the time that's all we need.
It's not always, but, you know,a lot of the time we just need
to create the right environmentthat things will sort themselves
(36:51):
out.
Speaker 1 (36:53):
Right.
Can I ask also about species?
Not necessarily strains here,because we're talking food, but
things like, you know, yourfermented foods, so the
lactobacillus plantarums.
Then you've got cheeses, forinstance.
So we're talking short-chainfatty acids, lactic acid, the
(37:15):
propionibacterium Freudian Reiki.
There you go.
I remembered it.
In Swiss cheese it's Edamcheese, emmental cheese.
So these are foods.
We don't often think of them astherapy in this, certainly not
a cheese.
And then we've, you know,usually got this an idea of
(37:35):
trying to avoid too much dairy.
Do you find in the, in thisinstance, that some of these
foods can actually be useful?
Speaker 2 (37:44):
this is so interesting because you'd think
so with the strain specificityin those um foods.
But those foods also reallyhigh histamine producing foods.
So, you know, dairy they'rethings that are like cultured,
they're things that are, yes,they have the bacteria there,
but they also have this hugehistamine load.
(38:04):
So they're not necessarilythings that I would recommend
because of the histamine side ofthings.
There definitely are some foodsthat have more specific strains
for the vaginal microbiome.
So, um, coconut yogurt is one ofthem.
It's not dairy, it's, you know,coconut yogurt.
Um, it's really high inlactobacillus strains,
specifically because of the waythat they manufacture it.
(38:26):
So if you get a wild fermentedcoconut yogurt and coconut kefir
as well, um, actually, uh,cow's milk or goat's milk kefir
does have a lot less um lactoseand it does have the?
Um, the lactobacillus speciesin there as well.
So you can get away with someum, some dairy products there,
(38:47):
um, but yeah, so things like, uh, either the?
Um kefir or the coconut yogurt,um, also things like green tea,
like things that are, yes,they're antimicrobial but they
have a beneficial action on thelactobacillus species.
So we need to just think aboutis there any negative effect as
well?
Speaker 1 (39:06):
Yeah, sure, I've learned so much from this.
This is great, this is reallygood.
But I think it's really asalient point that you give me,
certainly, and that is to always, whatever you're thinking,
always keep in mind what youmight be producing.
Like you spoke about the um,the caprylic acid potentially,
the coconut oil, lubricantspotentially upsetting the um,
(39:30):
the ph of the vagina, and thenthe the um.
You know good dairy products ifyou like, but then they're high
histamine.
So you've always got to thinkabout this risk to benefit.
And what are you doing?
Are you causing collateraldamage?
Speaker 2 (39:43):
yeah, absolutely thinking about these things
holistically.
Yeah, thinking about the wholeperson and what is the effect,
and that's why it's really not Ihave this microbe and I'm going
to treat that it's.
I have this microbe.
Why did I get this microbe?
What's going wrong within mybody, or you know what do I need
to support, what body systemsaren't quite right, and you know
(40:03):
what other things is thismicrobe producing?
Some microbes produce their ownhistamine, so there's, yeah,
lots of other things that youneed to kind of think about.
Speaker 1 (40:12):
So what about other we've spoken about the now I've
gone blank the RC14 and the GR1.
Yeah, that's right.
So what are the probiotics Like?
What about lactobacillusrhamnosus GG, for instance, the
hero of all probiotics which Idon't believe in heroes, but do
(40:36):
you ever use like a concert ofthem?
Do you ever use probiotics ingeneral?
Speaker 2 (40:41):
yeah, I use a lot of different probiotics.
I'm really specific with theprobiotics that I use, but I do
use a lot of the lgg, therhamnosus lgg, if there's any
immune stuff going on, whichthere almost always is, but
especially if it's a really um,chronic or embedded infection,
um, specifically in aerobicvaginitis I use it a lot as well
(41:02):
, um, and in chronic, um thrush,because it is impacting the
stability of our mast cells andour ability to reduce or, you
know, clear out histamine.
So when histamine and theimmune system come into play,
I'm definitely thinking lgg aswell, and I'll often put people
on multiple probiotics justbecause I want really really
(41:25):
specific strains and I might doone, one type inside the vagina,
intravaginally and then onetype orally.
So I'm trying to impact theimmune system orally and the gut
microbiome to impact thevaginal microbiome, and then I
might want something that'shaving a really direct impact on
the vaginal microbiome.
Speaker 1 (41:45):
Gotcha this is so interesting.
I'm learning so much.
Unfortunately, we're sort ofrunning out of time, but I could
talk to you all day.
This is fantastic.
Thank you, Greta, can I ask?
So people are going to want toknow like have you got any
courses that you helppractitioners with, or have you
written articles?
Speaker 2 (42:05):
This is my ultimate goal.
Actually, within the next yearor two, I would like to have a
practitioner course.
At the moment, I just have awebinar that's for clients, so
people who are studentnaturopaths.
You probably will get somethingout of it, but it is definitely
aimed at clients more thanpractitioners.
So, yeah, keep an eye out.
In the next year or two, Ishould hopefully have a course
(42:26):
going for practitioners andgoing through the kind of
nuances of treatment with thevagina microbiome.
Speaker 1 (42:32):
We'll be hassling you to make sure that gets
completed.
It's too important.
I mean, look, it's tooimportant a topic.
Women are really suffering, god, the women that I sent to Moira
one woman she was just.
She was so angry in love withher husband, but furious that
every time they made lovesomething that was supposed to
bring them together she ended upwith this horrible infection
(42:53):
and she was again on the, butfurious that every time they
made love something that wassupposed to bring them together
she ended up with this horribleinfection and she was again on
the roundabout.
And it was just this circle ofdespondency.
So I'm glad that people likeyou and Moira obviously have
found some way of being able toreally intercede in a truly
therapeutic way to help peoplewithin their lives.
(43:13):
I just love what you're doing.
Thank you so much.
Speaker 2 (43:16):
Thank you, yeah, thank you, it's yeah, and I just
can't go unmentioned that thishas such a huge impact on
people's mental health and justyour sense of self and sexuality
and you know, your your kind ofsensual self.
It can put you right off sex.
So I think it's reallyimportant that we're talking
about it now and there's a lotmore information out there.
Speaker 1 (43:39):
Greta Durston.
Thank you so much for joiningus today and thank you everyone
for joining us.
Remember you can pick all ofthe other podcasts on the
Designs for Health website.
I'm looking forward to awebinar from you soon, greta,
and all of the information.
We're going to put up as muchresearch as we can.
That's pertinent for thevaginal microbiome biota,
(44:00):
because it's such an importantand interesting topic and it's
moving ahead quite quickly now.
Thank you so much for joiningus today.
This is Wellness by Designs andI'm Andrew Whitfield-Cook.
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